Dept of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
Both authors contributed equally.
Eur Respir Rev. 2022 Jul 12;31(165). doi: 10.1183/16000617.0023-2022. Print 2022 Sep 30.
The impact of pulmonary embolism response teams (PERTs) on treatment choice and outcomes of patients with acute pulmonary embolism (PE) is still uncertain.
To determine the effect of PERTs in the management and outcomes of patients with PE.
PubMed, Embase, Web of Science, CINAHL, WorldWideScience and MedRxiv were searched for original articles reporting PERT patient outcomes from 2009. Data were analysed using a random effects model.
16 studies comprising 3827 PERT patients and 3967 controls met inclusion criteria. The PERT group had more patients with intermediate and high-risk PE (66.2%) compared to the control group (48.5%). Meta-analysis demonstrated an increased risk of catheter-directed interventions, systemic thrombolysis and surgical embolectomy (odds ratio (OR) 2.10, 95% confidence interval (CI) 1.74-2.53; p<0.01), similar bleeding complications (OR 1.10, 95% CI 0.88-1.37) and decreased utilisation of inferior vena cava (IVC) filters (OR 0.71, 95% CI 0.58-0.88; p<0.01) in the PERT group. Furthermore, there was a nonsignificant trend towards decreased mortality (OR 0.87, 95% CI 0.71-1.07; p=0.19) with PERTs.
The PERT group showed an increased use of advanced therapies and a decreased utilisation of IVC filters. This was not associated with increased bleeding. Despite comprising more severe PE patients, there was a trend towards lower mortality in the PERT group.
肺栓塞反应团队（PERT）对急性肺栓塞（PE）患者治疗选择和结局的影响仍不确定。
确定 PERT 在 PE 患者管理和结局中的作用。
检索了 2009 年以来发表的关于 PERT 患者结局的原始文章，包括 PubMed、Embase、Web of Science、CINAHL、WorldWideScience 和 MedRxiv。使用随机效应模型进行数据分析。
纳入了 16 项研究，共 3827 例 PERT 患者和 3967 例对照。与对照组（48.5%）相比，PERT 组中具有中高危 PE 的患者更多（66.2%）。荟萃分析显示，PERT 组接受导管定向介入治疗、全身溶栓和手术取栓的风险增加（比值比（OR）2.10，95%置信区间（CI）1.74-2.53；p<0.01），出血并发症相似（OR 1.10，95%CI 0.88-1.37），下腔静脉（IVC）滤器的使用率降低（OR 0.71，95%CI 0.58-0.88；p<0.01）。此外，PERT 组的死亡率呈下降趋势（OR 0.87，95%CI 0.71-1.07；p=0.19），但无统计学意义。
PERT 组显示出更倾向于使用高级治疗方法，同时减少了 IVC 滤器的使用。这与增加出血无关。尽管 PERT 组患者的 PE 更严重，但死亡率呈下降趋势。
